title: Multidisciplinary intervention reducing readmissions in medical inpatients: a prospective, non-randomized study.
abstract: BACKGROUND
  The purpose of this study was to examine whether a multidisciplinary intervention targeting drug-related problems, cognitive impairment, and discharge miscommunication could reduce readmissions in a general hospital population.
  
  
  METHODS
  This prospective, non-randomized intervention study was carried out at the department of general internal medicine at a tertiary university hospital. Two hundred medical inpatients living in the community and aged over 60 years were included. Ninety-nine patients received interventions and 101 received standard care. Control/intervention allocation was determined by geographic selection. Interventions consisted of a comprehensive medication review, improved discharge planning, post-discharge telephone follow-up, and liaison with the patient's general practitioner. The main outcome measures recorded were readmissions and hospital nights 12 months after discharge. Separate analyses were made for 12-month survivors and from an intention-to-treat perspective. Comparative analyses were made between groups as well as within groups over time.
  
  
  RESULTS
  After 12 months, survivors in the control group had 125 readmissions in total, compared with 58 in the intervention group (Mann-Whitney U test, P = 0.02). For hospital nights, the numbers were 1,228 and 492, respectively (P = 0.009). Yearly admissions had increased from the previous year in the control group from 77 to 125 (Wilcoxon signed-rank test, P = 0.002) and decreased from 75 to 58 in the intervention group (P = 0.25). From the intention-to-treat perspective, the same general pattern was observed but was not significant (1,827 versus 1,008 hospital nights, Mann-Whitney test, P = 0.054).
  
  
  CONCLUSIONS
  A multidisciplinary approach, targeting several different areas, could substantially lower readmissions and hospital costs in a non-terminal general hospital population.
authors.affiliation: Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
authors.forename: Gustav
authors.initials: G
authors.lastname: Torisson
authors.forename: Lennart
authors.initials: L
authors.lastname: Minthon
authors.forename: Lars
authors.initials: L
authors.lastname: Stavenow
authors.forename: Elisabet
authors.initials: E
authors.lastname: Londos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D006785:Hospitals, University; D006801:Humans; D033183:Interdisciplinary Communication; D010359:Patient Readmission / Q000639:trends*; D011446:Prospective Studies; D036301:Qualitative Research; D019966:Substance-Related Disorders / Q000628:therapy*; D013548:Sweden; D062606:Tertiary Care Centers
keywords: cognitive impairment; drug-related problems; hospital discharge; hospital readmissions; intervention; medical inpatients